Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
JACC Cardiovasc Interv. 2020 Oct 26;13(20):2402-2414. doi: 10.1016/j.jcin.2020.06.053. Epub 2020 Sep 30.
The primary objective of this study was to evaluate the effectiveness of the MitraClip G4 in the reduction of mitral regurgitation (MR).
The next-generation MitraClip G4 system was recently introduced for the treatment of MR in the United States.
The study included consecutive patients undergoing transcatheter mitral edge-to-edge repair for MR with the MitraClip G4. The key outcome was the proportion of patients with MR reduction to ≤2+ at 30 days.
Fifty-nine patients (median age 77 years, 62.7% men) were treated with the MitraClip G4. Reduction of MR to ≤2+ was achieved in 57 patients (96.6%) during the procedure, 58 patients (98.3%) at discharge, and 57 patients (96.6%) by 30 days. The median number of MitraClips used per patient was 2 (interquartile range: 1 to 3). Wide clips (NTW/XTW) were used in 82.7% of patients. The XTW clip was used most frequently as the first clip in patients with degenerative MR (65.4%) and the NTW clip in those with secondary MR (72.7%). The independent grasping mechanism was used in 49.2% of patients.
Use of the MitraClip G4 system was associated with excellent reduction in MR to ≤2+ in 96.6% of patients at 30 days. The availability of multiple MitraClip G4 sizes, especially the wide clips, and the ability to independently grasp leaflets are the likely contributors to MR reduction.
本研究的主要目的是评估 MitraClip G4 在减少二尖瓣反流（MR）方面的有效性。
新一代 MitraClip G4 系统最近在美国被引入用于治疗 MR。
该研究纳入了连续接受 MitraClip G4 经导管二尖瓣缘对缘修复治疗的 MR 患者。主要结局是 30 天内 MR 减少至≤2+的患者比例。
59 例患者（中位年龄 77 岁，62.7%为男性）接受了 MitraClip G4 治疗。在手术过程中，57 例（96.6%）、58 例（98.3%）和 57 例（96.6%）患者的 MR 减少至≤2+，出院时和 30 天时。每位患者使用的 MitraClip 中位数为 2（四分位距：1 至 3）。宽夹（NTW/XTW）在 82.7%的患者中使用。在退行性 MR 患者中（65.4%），最常使用 XTW 夹作为第一个夹，在继发性 MR 患者中（72.7%）使用 NTW 夹。独立抓取机制在 49.2%的患者中使用。
在 30 天时，使用 MitraClip G4 系统可使 96.6%的患者的 MR 减少至≤2+，效果极佳。多种 MitraClip G4 尺寸的可用性，特别是宽夹，以及独立抓取瓣叶的能力，可能是 MR 减少的原因。
